Provider Demographics
NPI:1679233027
Name:JOHN, JAIME (CPNP-PC, RN-MSN)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:JOHN
Suffix:
Gender:F
Credentials:CPNP-PC, RN-MSN
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:
Other - Last Name:POLLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6614 GRAY ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-4346
Mailing Address - Country:US
Mailing Address - Phone:224-545-4899
Mailing Address - Fax:
Practice Address - Street 1:195 W 14TH STE C
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650-4717
Practice Address - Country:US
Practice Address - Phone:970-945-2840
Practice Address - Fax:970-945-2893
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996017-NP363LP2300X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care